I have recently been using a successful protocol that I will run for a few months before the extended and extensive account is posted. It is based on taking a more focused approach to physical treatment to then build confidence that increases dopamine. This gave me some full nights of sleep.

However there are two experiences which have been successful and worth getting some feedback on, or at least offer it to those who are interested now.

This is for calf and foot muscle cramps and aches, without using any meds.

Blood Flow Restriction (BFR)

You will need to find something to make a tourniquet with. The best is a wide elastic bandage or knee wrap. I found a knee wrap in my local pharmacy/chemist/drug store in the sports section. It is about 1 metre long, 10 cm wide, elasticised with Velcro on both ends.

This always works for me. Wrap the elastic wrap/bandage above your knee very tightly with your muscles relaxed as much as possible and keep the wrap away from the patella. Then lie down in bed on your back and move your foot around, isometric stretch using your other leg as resistance or you can get up and do some one leg calf raises to speed up the process. Then lie back down and relax to check if it has worked. It should take around 20 minutes.

If the alarm bells are going off in your head, as long as you use a wide bandage you will not do any damage. BFR is used widely in body building with no problems. Of course if it is really painful or there are problems afterward then discontinue. The compression wrap/bandage is uncomfortable so you will not fall off to sleep and wake up with a dead leg, but if you are on your back with the covers off, this is then even less likely.

With the blood being restricted to the activated muscles during the cramps and aches, they run out of oxygen and glucose, build up metabolites, and stop cramping. When the cramps and aches stop, release the wrap/bandage and your calf should feel relaxed. This is always effective, as the cramped muscles you can’t find or stretch properly eventually run out of energy and relax.

If it doesn’t work in 20 minutes it is because the wrap isn’t tight enough, or if done below the knee, blood is still feeding the cramping muscles at the top of your calf. You will then need to release the wrap/bandage and try again, this time tighter.

Catching a Cramp

I found this by accident and it may not work for everyone, but if does it will change your night. We all instinctively move our legs to stop the cramp, DON’T do this but lay straight, flat on your back and ride out the cramps with legs totally relaxed. It took me a while to resist the urge to move and was also confused as to why it is so uncomfortable, even though it isn’t painful.

When the cramp starts to build, lie still and relaxed keeping your legs straight and relaxed, and then sit up, still keeping your legs straight and relaxed, reaching with your hands to feel on your calf muscle where the cramp is. What happened to me is that the cramp stopped immediately and didn’t return until later in the night; where I successfully did this again. The calf may still ache and keep you awake, but you have stopped the cramping.

I looked forward to trying this on the next night, but the cramp was very light and it didn't work. On successive nights the cramps stopped appearing. I have no explanation for this, but my guess is that timing is critical for when you reach for the cramps and there is a psychological aspect of you ‘connecting’ with an involuntary response. You may also get a dopamine boost due to confidence if it works.

If you can catch the cramp, you can press on the area cramping to release it or at least know the area that is being activated and work on it with pressure or stretching.

Cramps are not a part of WED/RLS, although some WED/RLS patients experience cramps as well. Since moving can alleviate a cramp, the desire to move and alleviate it might lead to misidentification of recurring nighttime cramps as WED/RLS. WED/RLS sensations don't have the physical focus or sharpness of a cramp, they're more diffuse. If you lie down again after you've gotten up to alleviate the feeling, it will come back right away or almost right away if it's WED/RLS. In WED/RLS, the urge to move increases when you lie still or are confined some way (like in the window seat of an airplane). If it's WED/RLS, the relief when you stand up is instant.

Do you have RLS/WED in addition to nighttime cramps? Your advice about getting rid of cramps is very interesting and new to me.

When I refer to a cramp I mean that moving fade in and out sporadic tightening sensation that is not painful but very uncomfortable. They activate the larger and smaller muscles, but the cramps aren’t strong enough to make my foot move, so the source isn’t clear. I've spent up to 2 hours trying everything I could think of to stop them, but they persist with a frequency of around 2 per minute when lying back down. Spasm would be a better description, but it is technically a periodic cramp.

Aches are the constant tightening of the muscles that are uncomfortable enough to keep me awake at night and sometimes felt during the day.

I'm still going through cycles of good and bad nights but only persistent aching. I'm doing pre-sleep targeting of tight areas which is making a massive difference, but I would like to run it for a bit longer before I post anything.

Overall the advice for pure physical treatment and relief is completely misleading. I'm working on that at the moment, with the posts above leading to big improvements so far. Some of the techniques I'm working on should translate to everyone, the problem being that there is some skill involved. This can be learn't.